Systems and Methods for Administering Work Absence Insurance

ABSTRACT

A computer receives rating information relating to proposed issuance of an insurance policy endorsement. The rating information relates to a proposed insured that employs a number of employees. The computer processes the rating information to generate a premium amount to be charged for the insurance policy endorsement. The endorsement is then issued. The endorsement may provide reimbursement to the insured for losses incurred by the insured arising from absence from work by one or more of the employees.

CROSS-REFERENCE TO RELATED APPLICATION

The present application is a continuation of copending U.S. patentapplication Ser. No. 12/840,680 entitled Systems and Methods forAdministering Extended Absence Insurance, filed on Jul. 21, 2010, theentire contents of which application are incorporated herein byreference for all purposes.

FIELD

The present invention relates to data processing systems operated inconnection with issuance and administration of insurance contracts.

BACKGROUND

When an injury occurs in the workplace, the affected employee isentitled to receive benefits under a workers' compensation (WC)insurance policy that has been obtained by the employer. Among thebenefits available under WC policies is compensation for lost wages forperiods during which the employee is absent from work due to the injury.For some workers, short or long term disability coverage may beavailable to partially replace lost wages, in cases where the disabilitydid not result from an injury on the job. Usually an employee does notreceive salary or wages from the employer while the employee isreceiving WC or disability benefits.

Workers' compensation insurance and disability coverage provide benefitsto employees, but do not reimburse employers for increased costs orother losses that may accrue to the employer due to an employee'sabsence from work. (Typically a WC policy provides benefits only toinjured employees and does not provide any benefit payments to anemployer.) For example, while an employee is absent, the employer mayneed to pay overtime compensation to other employees who take over tasksthat would otherwise have been performed by the absent employee. Also,the employer may incur expenses related to hiring of a temporary orpermanent replacement for the injured employee. Under somecircumstances, it may not be feasible to replace the employee for aperiod of time, and the absence of the employee may prevent the employerfrom realizing revenue that would have been obtained if the employee hadnot been absent. Moreover, even in cases where a temporary or permanentreplacement is hired, or fellow employees work extended hours to coverfor the absent employee, some revenue opportunities may be lost.

SUMMARY

An apparatus, method, computer system and computer-readable data storagemedium are disclosed which include receiving rating information withrespect to an employer for a proposed insurance policy endorsement tocover losses due to employee absence. The rating information isprocessed to generate the amount of premium payment that is applicableto the proposed endorsement. The insurance company issues theendorsement, which will reimburse the employer for at least some lossesarising from absence from work by one or more employees. The endorsementmay, for example, be included in a workers' compensation,property/casualty policy, group life insurance policy or group healthinsurance policy issued to the employer.

With these and other advantages and features of the invention that willbecome hereinafter apparent, the invention may be more clearlyunderstood by reference to the following detailed description of theinvention, the appended claims, and the drawings attached hereto.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 schematically illustrates an environment in which principles ofthe present invention may be applied.

FIG. 2 is a block diagram illustration of a computer system operated inaccordance with aspects of the present invention.

FIG. 3 is a block diagram that illustrates a server computer that ispart of the computer system of FIG. 1, and which is operated inaccordance with aspects of the present invention.

FIG. 4 is a flow chart that illustrates a process performed in theserver computer of FIG. 3 according to aspects of the present invention.

FIG. 5 is a screen display provided to a user of the computer system ofFIG. 2 in connection with the process of FIG. 4.

FIG. 6 is a flow chart that illustrates another process performed in theserver computer of FIG. 3 according to aspects of the present invention.

FIG. 7 is a screen display provided to a user of the computer system ofFIG. 2 in connection with the process of FIG. 6.

FIG. 8 is a block diagram that illustrates other aspects of the presentinvention.

DETAILED DESCRIPTION

In general, and for the purposes of introducing concepts of embodimentsof the present invention, an insurance company offers an endorsement toa workers' compensation policy or other type of policy to provide thepolicy holder with coverage against costs and/or lost revenue that mayarise from the extended absence (or assignment to restricted duty) ofone or more employees of the policy holder. In some embodiments, theendorsement may apply both to absences arising from WC-compensabledisabilities as well as absences due to other causes, such as illness orparental leave.

FIG. 1 schematically illustrates an environment in which principles ofthe present invention may be applied.

In FIG. 1, a factory 102 is schematically shown. The factory 102 employsemployees (not separately shown) in a number of job categories. Thefactory 102 is operated by a company that maintains workers'compensation coverage for its employees and also carries fire insuranceand possibly coverage for other risks to its real property (and/orcarries group life, health and/or disability insurance for itsemployees). The company that operates the factory 102 is a potentialcustomer for the type of employee absence coverage referred to above andprovided in accordance with aspects of the present invention.

At 104, an office building is indicated. The office building 104 may,for example, house administrative employees of the company that operatesthe factory 102. (Alternatively, the office building 104 may be operatedby another entity, such as a software company or other organization madeup primarily of office workers.) Like the factory 102, the officebuilding 104 may be the workplace of employees whose absence may tend toresult in unexpected expenses or loss of revenue to their employer. Thusthe employer of the workers in the office building 104 may also be apotential customer for employee absence coverage as described herein.

Reference numeral 106 indicates one or more server computers operated byan insurance company (not separately shown) that provides employeeabsence coverage in accordance with principles of the present invention.Reference numeral 108 indicates one of a number of personal and/orlaptop computers that are operated by insurance company employees andthat engage in data communications with the server(s) 106. The computers108 display information (reference numeral 109) to the users thereof. Atleast some of this information may be downloaded to the computers 108from the server computer(s) 106. In addition, reference numeral 110indicates one of a number of other end user computers operated byinsurance company employees.

The proprietor(s) of the factory 102 and/or the office building 104 mayengage in data communications, at least from time to time, with one ormore of the insurance company computers 106, 108, 110 (and/or withcomputers operated by agents for the insurance company). At least someof this communication may be via the Internet (reference numeral 112).Some of the communication may relate to data required to propose, rateand issue employee absence coverage policy endorsements, and to submitand handle claims made under such endorsements.

FIG. 2 is a block diagram illustration of a computer system 200 operatedin accordance with aspects of the present invention. The computer system200 includes a server computer 106 operated by the insurance company inconnection with issuance and administration of employee absence policyendorsements. The policy employee absence coverage can also be coveredby a stand alone policy. Also depicted in FIG. 2 is one of a number ofpersonal computers 202 that may be operated by an insured or potentiallyinsured entity for purposes of communicating with the issuance andadministration server computer 106. FIG. 2 further shows a typicalpersonal computer 108 operated by an individual employee of theinsurance company for the purpose of underwriting employee absencecoverage or handling claims made under such coverage.

Communications among the computers 106, 108 and 202 occurs via a datacommunication network 204, which may include the Internet and/or one ormore other public or private data networks. In their hardware aspects,all components of the computer system 200 may be conventional. However,one or more of the insurance company computers 106, 108 may beprogrammed to support operation of those computers in accordance withaspects of the present invention.

As seen from FIG. 2, the insurance company personal computer 108 mayhave a conventional hardware architecture. Thus the insurance companypersonal computer 108 includes a data bus 211. The insurance companypersonal computer 108 also includes a computer processor (CPU) 210 whichis operatively coupled to the data bus 211 and which may be constitutedby one or more conventional processors. The insurance company personalcomputer 108 further includes a network interface unit 212, systemmemory 213, one or more storage devices 214, and an input/outputcontroller 216, all of which are also operatively coupled to the databus 211.

The network interface unit 212 may function to facilitate communicationwith, for example, other devices (such as the issuance andadministration server computer 106). The input/output controller 216 maycouple the insurance company personal computer 108 to input and outputdevices (not shown in FIG. 2) such as a keyboard, a keypad, a mouse orother pointing device, a microphone, knob or a switch, an infra-red (IR)port, a docking station, a touch screen, a display (e.g., a displayscreen such as that seen at 113 in FIG. 1), a speaker, and/or a printer.

The system memory 213 may be constituted by, for example, a suitablecombination of Random Access Memory (RAM) devices 218 and Read OnlyMemory (ROM) devices 220.

Storage devices 214 may comprise any appropriate information storagedevice, including combinations of magnetic storage devices (e.g.,magnetic tape and hard disk drives), optical storage devices, and/orsemiconductor memory devices. At least some of these devices (and/or allor part of the system memory 213) may be considered computer-readablestorage media, or may include such media.

Storage devices 214 store one or more programs (at least some of whichbeing indicated by blocks 222, 224) for controlling CPU 200. CPU 200performs instructions of the programs, and thereby operates inaccordance with aspects of the present invention. In some embodiments,the programs may include one or more conventional operating systems,indicated by block 412 in FIG. 4. The programs may further includeapplication programs (block 224) such as a browser, a conventional datacommunication program and a conventional database management program.

There may also be stored in the storage devices 214 other software, suchas device drivers, etc.

Still further, the storage devices 214 may store one or more databases(block 226) for storing and managing the data relating to operation ofthe insurance company personal computer 108.

FIG. 3 is a block diagram representation of the issuance andadministration server computer 106. The issuance and administrationserver computer 106 may be conventional in terms of its hardwareaspects.

As depicted in FIG. 3, the issuance and administration server computer106 includes a processing module 302, which may be constituted by one ormore conventional computer processors. The issuance and administrationserver computer 106 further includes an endorsement issuance module 304,which receives information relative to the risks to be insured, andgenerates information for indicating the amount of premium payment to berequired for the proposed employee absence coverage policy endorsement.In addition, the endorsement issuance module 304 may generate documentsand data records required to accomplish issuance of the employee absencecoverage policy endorsement. The endorsement issuance module 304 may beconstituted, at least in part, by the processing module 302 incombination with suitable software program instructions. Aspects of thesoftware program instructions for the endorsement issuance module 304will be described below.

The issuance and administration server computer 106 further includes apolicy administration module 306 which stores, generates and retrievesinformation relating to administration of employee absence coveragepolicy endorsements. For example, the policy administration module 306may interact with a billing server (not shown) to incorporate billingfor the employee absence coverage policy endorsement into bills renderedby the insurance company to the insured, and to receive communicationsto indicate that premiums for the endorsement and underlying policy havebeen paid. Further, the policy administration module 306 may receiveinformation relating to claims under the employee absence coveragepolicy endorsement and may facilitate handling and resolution of suchclaims by claim handlers employed by the insurance company.

The policy administration module 306 may be constituted, at least inpart, by the processing module 302 in combination with suitable softwareprogram instructions. The policy administration module 306 may, forexample, interact with, or embody, a claim handling software applicationprogram that generally operates in accordance with conventionalprinciples. Such a claim handling application may be modified asrequired to support consideration and resolution of claims under theemployee absence coverage policy endorsement.

The issuance and administration server computer 106 further includes oneor more storage devices, represented by item 308 in FIG. 3. The storagedevices 308 are coupled for data communication with the processingmodule 302 and may comprise any appropriate information storage device,including combinations of magnetic storage devices (e.g., magnetic tapeand hard disk drives), optical storage devices, and/or semiconductormemory devices (such as Random Access Memory (RAM) devices and Read OnlyMemory (ROM) devices). At least some of these devices may be consideredcomputer-readable storage media, or may include such media. The storagedevices 308 may store the above-mentioned software program instructionsand/or other program instructions to control the processing module 302such that the issuance and administration server computer 106 providesdesired functionality, as described herein. Thus, the storage devices308 store one or more programs for controlling the processing module302. The processing module 302 performs instructions of the programs,and thereby operates in accordance with aspects of the presentinvention. In some embodiments, the programs may include one or moreconventional operating systems. The programs may further includeapplication programs such as a conventional data communication programand a conventional database management program. Aspects of theapplication programs will be described below.

The issuance and administration server computer 106 may further includeone or more communication devices 310 coupled to the processing module302. The communication devices 310 may function to facilitatecommunication with, for example, other devices, such as personalcomputers operated by insureds or prospective insureds and/or operatedby underwriting and claim handling employees of the insurance company.In addition, the issuance and administration server computer 106 mayinclude one or more input devices 312 such as a keyboard, a keypad, amouse or other pointing device, a microphone, knob or switch, aninfra-red (IR) port, a docking station and/or touch screen. The inputdevice(s) 312 may be coupled to the processing module 302. Stillfurther, the issuance and administration server computer 106 may includeone or more output devices 314, such as a display (e.g., a displayscreen), a speaker, and/or a printer. The output devices 314 may also becoupled to the processing module 302.

FIG. 4 is a flow chart that illustrates a process performed in theissuance and administration server computer 106 according to aspects ofthe present invention.

At 402 in FIG. 4, the issuance and administration server computer 106requests that an underwriting employee of the insurance company and/orthe prospective insured provide information required to generate a pricequotation for a proposed employee absence coverage policy endorsementfor the prospective insured. In some embodiments the endorsement inquestion may relate to a WC policy or to a property/casualty policy suchas a fire insurance policy or a commercial real property “all risks”policy. The information needed to rate the proposed coverage mayinclude, for example, a roster of some or all of the employees employedby the prospective insured, with their wage rates and their occupationor occupation category. For example, the employees may be categorized inthe same manner as for WC rating. The rating information may alsoinclude the location(s) of the prospective insured's facilities andexperience rating information for the prospective insured. If lostrevenue is to be compensable under the employee absence coverage policyendorsement, the rating information may include, for each employee orcategory of employees, the maximum daily or weekly dollar amount of lostrevenue that is to be compensable.

At 404 in FIG. 4, the issuance and administration server computer 106receives the requested rating information. In some embodiments, at leastsome of the rating information may be received from a payroll servicescontractor for the prospective insured. In this regard, the term“payroll services contractor” refers to a third party contractingcompany that handles bookkeeping and/or administrative tasks relating topayment of wages to the employees of the prospective insured. (Threewell known payroll services contractors are Paychex, Inc., Administaff,Inc. and Automatic Data Processing, Inc.)

At 406, the rating information received at 404 is stored in the storagedevice 308 (FIG. 3). At 408, the endorsement issuance module 304processes the stored rating information to determine what is theappropriate premium payment to be quoted for the proposed employeeabsence coverage policy endorsement.

In some embodiments, the premium to be quoted may be based on suchfactors as the estimated amount to be paid for each claim, thelikelihood that a claim will result, and a suitable factor to accountfor profit and expense ratio. The estimated amount to be paid for eachclaim, in turn, may be calculated based on a percentage (e.g., 50%,which may be the coverage limit) of the average weekly wage for eachemployee to be covered by the proposed employee absence coverage policyendorsement, multiplied by an estimate of how many weeks of absence, onaverage, will be covered for each claim. The latter estimate may bebased on a statistical analysis of employee absence data, such as dataregarding compensable absences in connection with WC claims. In someembodiments, the absence data that is analyzed for this purpose mayrelate to the industry in which the proposed insured operates. In someembodiments, disability data and/or absence data used for ratingpurposes may be obtained from sources internal to and/or external to theproposed insured employer. For example, payroll information used forrating purposes may be obtained directly or indirectly from data inputinto the employer's (or payroll service's) computer via a conventionalaccounting software package such as “QuickBooks”. In some embodiments,an experience rating for the proposed insured may also be applied. Theestimated absence information may also be based on data relating todisability claims and/or maternity leave absences, and may be based oninformation available internally to the employer and/or from externalsources.

In some embodiments, the premium rating process may be based on statedper employee rates that vary by state and/or by employee class code. Forexample, in one state the rate for office workers may be $0.20 per$100.00 of payroll; or $10.00 per $100.00 of payroll for constructionworkers. In some embodiments, for rating purposes each employee on thepayroll may be scheduled by occupation.

In some cases, the rating process for a given insured may involve textmining databases such as payroll and/or claims (e.g., WC claims)databases to classify the proposed insured's employees and to determinehistorical experiences for frequency and/or duration of claims.

For policies that cover additional expense due to employee absence, theprospective additional expense liability of the insurance company forrating purposes may be calculated as a product of (A) coverage factor(i.e., percentage of claimed expenses to be reimbursed); (B) averageweekly wage; (C) expected average duration of loss periods; and (D)expected utilization. For policies that cover lost business income dueto employee absence, the prospective liability of the insurance companymay be calculated for rating purposes as a product of (A) benefit level;(B) average wage; (C) expected average duration of loss periods; and (D)expected utilization. After a period of experience with employee absencecoverage, rating may be based on actual average duration andutilization, for example. In addition or alternatively, the rates forthis coverage may be stated as an add-on factor to WC coverage rates.

In some embodiments, rates may be tiered by industry (of the insured),based for example on market data.

Premium rates may be calculated in some embodiments by automaticallyapplying rate factors to payroll data for the prospective insuredemployer.

More generally in relation to setting rates for an employee absenceendorsement, elements of loss costs, unallocated expenses and expectedprofit may all be considered.

Loss costs may consist of the amount that will be paid as a benefit tothe insured, as well as any additional expenses directly allocated toclaims. For example, when an employee is injured and will miss time fromwork during his/her recovery, the costs paid by the insurer to theemployer constitute loss costs. Additionally, any direct payments madein connection with adjusting the claim would be included in thecalculation of loss costs. In establishing an estimate of loss costs,historical claims experience for WC claims may be examined as to averageweekly wage and claim duration for all claims over a period of time.Claim duration and average weekly wage may be analyzed by industry,geographically and/or according to other variables. Allocated expensesmay include litigation, investigation, and other costs associated with aclaim that are not paid directly to the insured.

Unallocated expenses may include costs for underwriting, claimsadjusting, and systems support. These costs may be expressed aspercentages of the overall premium. Other unallocated expenses may becommissions paid to agents, taxes/licensing/fees (TL&F), otherunderwriting expense (OUE) and unallocated loss and expense (LAE) forclaims handling.

In some embodiments, the endorsement issuance module 304 may generate arespective proposal (premium payment quotation) for each of severallevels of possible employee absence coverage. According to a basic levelof coverage, the duration of coverage for each absence may be limited toa basic duration, such as 30 days. According to an intermediate level ofcoverage, the duration of coverage for each absence may be limited to anintermediate duration, such as 60 days. According to a maximum level ofcoverage, the duration of coverage for each absence may be limited to amaximum duration, such as 90 days. (It will be appreciated that theseare only example durations, and may vary in particular embodiments ofthe invention.) The length of maximum covered duration for each level ofcoverage may affect the estimated duration of each absence for whichclaims may be made, and thus may affect the proposed premium paymentthat is quoted for each level of coverage. In some embodiments, theduration of coverage(s) provided or available may vary according to theindustry in which the proposed insured operates.

In some embodiments, there may be differences among the coverage levelsin terms of what types of absence are covered. For example, in the basiccoverage level, it may be the case that only WC compensable absences arecovered. The intermediate level may cover both WC compensable absences,plus absences that are covered for employee benefits under a disabilityinsurance plan. The maximum level may cover any absence except absencedue to termination of employment. These varying types of covered absencemay affect the estimated likelihood of claims taken into account incalculating the quoted premium for each level of coverage.

In some embodiments, the employee absence endorsement may also providecoverage for expenses incurred by the covered employer in cases where aninjured employee remains on the job but is restricted to light duty. Forexample, recovered expenses in such a case may include overtime costsfor another employee or employees to cover for the employee who is onrestricted duty.

The coverage levels may also vary in terms of the weekly dollar limitthat is applicable to each claim. For example, for the basic level thecoverage limit may be 50% of the absent employee's average weekly wage.For the intermediate level, the coverage limit may be 75% of the absentemployee's average weekly wage. For the maximum coverage level, thecoverage limit may be 100% of the absent employee's average weekly wage.These different coverage limits may lead to differing estimates as tothe expected average total payment per claim to be used in calculatingthe quoted premium payment for each level of coverage.

Where the proposed employee absence coverage policy endorsement includescoverage for lost revenue, the rating information way include a schedulethat sets a limit for the weekly or monthly lost revenue that may beclaimed for each employee. These limits and the classifications of theemployees may be factors used by the endorsement issuance module 304 inestimating the probable amounts and likelihoods of claims under thisaspect of the endorsement.

As a result of the calculations described above, the endorsementissuance module 304 may produce one or more proposed premium quotationsat step 408 (FIG. 4). The resulting proposed premium quotations may bedisplayed by the computer system 200 to the underwriting employee(underwriter) of the insurance company and/or to the proposed insured.FIG. 5 shows a simplified example of a suitable screen display fordisplaying proposed premium quotations to the underwriter/insured. Forexample, this screen display may be downloaded from the issuance andadministration server computer 106 (FIG. 2) to the insurance companyunderwriter personal computer 108 and/or to the insured's personalcomputer 202 for display by the display units of the personalcomputer(s) 108 and/or 202.

Referring again to FIG. 4, at 410 the issuance and administration servercomputer 106 may receive an indication that the proposed insured hasaccepted one of the proposed levels of coverage and has agreed to theproposed premium payment. For example, this indication may take the formof a signal sent from the underwriter personal computer 108 or theinsured's personal computer 202. In response to this indication, theendorsement issuance module 304 of the issuance and administrationserver computer 106 may (at 412) generate one or more schedules requiredto document the proposed employee absence coverage policy endorsement.Also, at 414, the endorsement issuance module 304 may generate suitableinsurance policy endorsement documents for the proposed endorsement. At416, the endorsement issuance module 304 may issue the employee absencecoverage policy endorsement. This may involve sending thedocument(s)/schedules by physical and/or electronic mail to the insured.In addition, the endorsement issuance module 304 may cause suitable datarelating to the endorsement to be stored in connection with the policyadministration module 306 of the issuance and administration servercomputer 106. Issuance of the employee absence coverage policyendorsement may also involve billing of the premium to the insured. Insome embodiments, the billing for the endorsement may take placeautomatically through a payroll services company retained by the insuredemployer.

In some embodiments, payroll information upon which the premium iscalculated may be subject to audit (e.g. in similar fashion to auditingfor WC coverage premiums). The premium may be subject to change as theinsured's payroll and/or roster of covered employees changes. A premiumaudit with respect to the endorsement may also be triggered by or basedon information received by the insurer in adjusting or handling one ormore claims under the endorsement. More specifically, submission of aclaim may trigger a premium audit workflow process. The workflow processmay provide for examination of the records of a policyholder employer todetermine the accuracy of the estimated policy premium in force in viewof the submitted claim.

The premium audit may indicate if any additional premium is owed to theinsurer or any credits are to be received by the insured based onpayroll adjustments by the audit process which may uncoverover-reporting, under-reporting or mis-reporting of workers andcorresponding classifications.

In some embodiments, the employee absence coverage policy endorsementmay be issued as an endorsement to an existing WC policy in force fromthe insurance company for the insured entity. Alternatively, theemployee absence coverage policy endorsement may be an endorsement to aproperty/casualty policy or to another type of policy. Moreover, theendorsement may be issued in connection with issuance of a new WC,property/casualty, group life, group benefits, or other type ofinsurance policy.

The resulting policy endorsement may provide insurance coverage thatreimburses the insured employer for costs related to hiring areplacement worker for a limited period of time during the absence fromwork of an individual employed by the insured. In addition oralternatively, the endorsement may provide reimbursement to the employerfor overtime compensation paid by the employer to other regularemployees to cover duties assigned to the absent employee. Theendorsement may also cover other types of expenses arising from employeeabsence, such as travel and/or living expenses reimbursed by theemployer to a replacement employee or employees. In addition oralternatively, the endorsement may reimburse the employer for revenuelost due to an employee's absence.

In some embodiments, there may be a waiting period, such as one weekaway from the job, before an employee's absence gives rise to a claimunder the endorsement.

In some embodiments, the amount reimbursable to the insured employer maybe subject to a per employee, per period cap. The cap may be scheduledin the endorsement by employee and/or by category of employee.

In some embodiments, the duration of the absence for which coverageapplies may be subject to a time limit. The time limit may vary by classof employee. For example, for employees who hold physically demandingjobs, the time limit may be longer than it is for office workers.

It may be a requirement under the endorsement that the employerdemonstrate its actual replacement/overtime costs or lost revenues dueto the absence of the employee. In some embodiments, the coveragereimburses less than 100% (for example, 75%) of the demonstratedcost/lost revenue.

In some embodiments, a deductible and/or coinsurance may apply. In someembodiments, benefits under the employee absence endorsement may be paidweekly or on some other periodic basis or on a one-time basis (e.g., atthe end of the covered absence).

FIG. 6 is a flow chart that illustrates a process performed in theissuance and administration server computer 106 according to aspects ofthe present invention with respect to a typical claim under an employeeabsence coverage policy endorsement.

At 602 in FIG. 6, the issuance and administration server computer 106(i.e., the policy administration module 306) receives informationrelated to a claim under the employee absence coverage policyendorsement. For example, the claim information may be received from aclaim handler employee of the insurance company (e.g., via the personalcomputer 108) or by an administrative/data entry employee of theinsurance company, or directly from the insured (e.g., via the insured'spersonal computer 202).

The claim information may include, for example, the name and otheridentifying information for the employee who has been absent from work,the cause of the absence, and details concerning the costs incurred bythe employer and/or revenues lost by the employer due to the absence.

At 604, the policy administration module 306 may store the claiminformation in the storage device 308 of the issuance and administrationserver computer 106. At 606, the policy administration module 306retrieves the claim information from the storage device 308 for furtherprocessing.

At 608 the policy administration module 306 processes the retrievedclaim information. For example, the policy administration module 306 mayapply coverage rules such as any applicable caps, limits on the durationof covered absences and/or factors that reflect the proportion of lossthat is reimbursable under the employee absence coverage policyendorsement. These coverage rules can be selectively applied dependingupon the characteristics of the policy endorsement which are stored in adatabase in the data processing system. The outcome of the processingmay be an amount that is reimbursable to the insured for the claim. Datareflecting the results of the processing at 608 may be stored in thestorage device 308 and downloaded by the policy administration module306 to the insurance company computer 108 operated by the claim handlerassigned to the claim.

At 610, the claim handler's computer 108 displays to the claim handlerthe data downloaded from the policy administration module 306 of theissuance and administration server computer 106 regarding the claim.FIG. 7 is a simplified example screen display that may be displayed atstep 610 by a display component of the claim handler's computer 108. Theclaim handler may take various steps to review the information providedby the policy administration module 306 and/or stored in the storagedevice 308 relating to the claim. For example, the claim handler may“drill down” to review details of the claim information. He/she may, forexample, interview an administrative employee at the claimant/insuredcompany to verify some or all of the claim information. He/she maycompare the claim with other claims previously received from theclaimant. He/she may also obtain relevant information from thirdparties.

For example, as illustrated in FIG. 8, one or more payroll servicescontractors 802 may provide information to the issuance andadministration server computer 106 of the insurance company to indicatefor a given insured whether or not particular employees of the insuredhave been compensated for a given pay period, and if so, how much. (Inthe drawing, the payroll services contractors 802 are represented by atypical laptop computer, which may be operated by such a contractor andwhich may store and transmit payroll-related information, schematicallyindicated at 803.) The claim handler may, for example, use thisinformation to verify that the claimed absence has indeed occurred, atleast as reflected in payroll records for the insured. The claim handlermay also use this information to verify payment of overtime compensationto other employees.

Further, FIG. 8 shows “badge readers” 804 as another source ofinformation that may be uploaded to the issuance and administrationserver computer 106. By “badge readers”, this disclosure refers todevices installed and used at employer locations to read employeeidentification badges issued to employees. The reading technologyinvolved may be, for example, RFID or magnetic stripe reading. Forexample, a typical badge reader may include a reading/scanning element806 that reads an employee badge 808. The badge readers 804 may functionto grant access to the company facilities and/or to sign in employeesand/or to sign out employees at the employer's premises. Informationuploaded from the badge readers 804 to the issuance and administrationserver computer 106 may indicate dates and/or times when individualemployees logged in or out of their employers' premises. The claimhandler may refer to information uploaded to the issuance andadministration server computer 106 from the insured's badge reader(s) toverify that the employee claimed to be absent was not logging in at theemployer's premises during the claimed period of absence. In addition,or alternatively, the claim handler may use information uploaded to theissuance and administration server computer 106 from the insured's badgereader to confirm the claimed overtime work by other employees.

Referring again to FIG. 6, at 612 the policy administration module 306of the issuance and administration server computer 106 may receive inputfrom the claim handler to indicate that the claim handler authorizespayment of the claim as proposed by the results of the processing of theclaim by the policy administration module 306. For example, the claimhandler may provide this input by actuating (“clicking on”) the“Approve” button 702 shown in the screen display illustrated in FIG. 7.At 614, the policy administration module 306 may receive inputindicating that a supervisory employee in the claims department hasreviewed and approved the claim handler's decision to pay the claim.Then, at 616, the policy administration module 306 may issue payment forthe claim to the insured employer.

The input from the payroll services contractors 802 and/or the badgereaders 804 was described above as being used in the claim handlingprocess. In addition, or alternatively, this information may be used ina post-audit of claim handling and payment activities. For either orboth purposes, information from the payroll services contractor or fromthe employer may be used to verify baseline payroll information for theemployees, to verify the average weekly wages for the employees, and/orto verify that a light duty assignment is actually occurring (e.g., byverifying that the wages paid to the employee have been decreased).

Insurance coverage for employer costs/losses due to employee absence hasbeen described above as being issued as an endorsement to a WC policy, aproperty/casualty insurance policy, or another type of policy.Alternatively, however, such coverage may be provided in a stand-aloneinsurance policy.

Processes portrayed herein as being performed by one computer may inpractice be divided among two or more computers. Processes portrayedherein as being performed by two or more computers may in practice beperformed by a single computer.

The process descriptions and flow charts contained herein should not beconsidered to imply a fixed order for performing process steps. Rather,process steps may be performed in any order that is practicable.

As used herein and in the appended claims, “employee absence” (or“absence from work by an employee”) should be understood to includeassignment of an employee to restricted duty due to injury or illness.

As used herein and in the appended claims, the term “hiring areplacement worker” refers both to directly hiring a worker and tohiring a worker via a temporary employment agency or the like.

As used herein and in the appended claims, the term “computer” refers toa single computer or to two or more computers in communication with eachother and/or operated by a single organization or by two or moreorganizations that are partly or entirely under common ownership and/orcontrol.

As used herein and in the appended claims, the term “processor” refersto one processor or two or more processors that are in communicationwith each other.

As used herein and in the appended claims, the term “memory” refers toone, two or more memory and/or data storage devices.

The present invention has been described in terms of several embodimentssolely for the purpose of illustration. Persons skilled in the art willrecognize from this description that the invention is not limited to theembodiments described, but may be practiced with modifications andalterations limited only by the spirit and scope of the appended claims.

What is claimed is:
 1. A computer system for issuing insurance policycoverage for work absences, the computer system comprising: one or moredata storage devices; one or more computer processors in communicationwith the one or more data storage devices; a communications device incommunication with the one or more computer processors and the one ormore data storage devices; and a memory, coupled to the one or morecomputer processors, storing program instructions which, when executedby the one or more computer processors, cause the one or more computerprocessors to: receive, via the communications device, ratinginformation with respect to a proposed insured, the proposed insuredbeing an employer of a plurality of employees; storing the receivedrating information in the one or more storage devices; process therating information to generate a premium amount for the insurance policycoverage; and issue the insurance policy coverage corresponding to thepremium amount, wherein the coverage provides a benefit to the proposedinsured for a loss arising from an absence from work by at least one ofthe employees of the proposed insured.
 2. The computer system of claim1, wherein the generated premium amount corresponds to benefit durationlimits based on a class of each of the plurality of employees andwherein the issued insurance policy coverage comprises the benefitduration limits based on the class of each of the plurality of employees3. The computer system of claim 1, wherein the insurance policy coveragecomprises an endorsement to at least one of: (a) a worker's compensationinsurance policy, and (b) a property casualty insurance policy.
 4. Thecomputer system of claim 1, wherein the insurance policy coveragecomprises a stand-alone insurance policy.
 5. The computer system ofclaim 1, wherein the loss includes one of a cost of hiring a replacementworker to perform tasks assigned to the at least one of the employees, acost of paying overtime compensation to other employees to perform tasksassigned to the at least one of the employees, and a loss of revenue dueto the absence.
 6. The computer system of claim 1, wherein the memorystoring program instructions that cause the one or more computerprocessors to process the rating information to generate the premiumamount and issue the insurance policy coverage comprises the memorystoring program instructions that cause the one or more computerprocessors to: generate a respective premium payment quotation for eachof several levels of possible employee absence coverage; receive, fromthe proposed insured, a selection of one of the respective premiumpayment quotations corresponding to a selected level of employee absencecoverage; and issue the insurance policy coverage corresponding to theselected one of the respective premium payment quotations correspondingto the selected level of employee absence coverage.
 7. The computersystem of claim 6, wherein each of the several levels of possibleemployee absence coverage covers a different type of possible coverage.8. The computer system of claim 7, wherein the different types ofpossible coverage include one of workers' compensation coverage anddisability insurance coverage.
 9. The computer system of claim 6,wherein each of the several levels of possible employee absence coverageincludes a weekly dollar limit applicable to each claim based on apercentage of an absent employee's weekly wage.
 10. The computer systemof claim 1, wherein the rating information includes a schedule that setsa limit for the weekly or monthly lost revenue that may be claimed foreach employee.
 11. The computer system of claim 1, wherein the premiumamount is calculated based on one or more of: (a) total payroll amountfor the employer; (b) categories of the employees; and (c) lossexperience of the employer.
 12. A computer-implemented method of issuingan insurance policy coverage for work absences, the method comprising:receiving, by one or more computer processors, rating information withrespect to a proposed insured, the proposed insured being an employer ofa plurality of employees; storing the rating information in one or moredata storage devices; processing, by the one or more computerprocessors, the rating information to generate a premium amount for theinsurance policy coverage; and issuing, by the one or more computerprocessors, the insurance policy coverage, the coverage for reimbursingthe proposed insured for at least some loss incurred by the proposedinsured arising from absence from work by at least one of the employees.13. The computer-implemented method of claim 12, further comprisingtransmitting, by a communications device, documents relating to theinsurance policy coverage to the proposed insured.
 14. Thecomputer-implemented method of claim 12, wherein issuing, by the one ormore computer processors, the insurance policy coverage comprises one ofissuing a stand-alone insurance policy and issuing an endorsement to atleast one of: (a) a worker's compensation insurance policy, (b) aproperty insurance policy, and (c) a casualty insurance policy.
 15. Thecomputer-implemented method of claim 12, wherein the loss includes oneof: (a) expenses incurred by the employer in cases where an injuredemployee remains on a job but is restricted to light duty; (b) expensesincurred by the employer for another employee or employees to cover foran employee who is restricted to light duty; and (c) a loss of revenuedue to the absence.
 16. The computer-implemented method of claim 12,wherein generating the premium amount for the insurance policy coverageand issuing the insurance policy coverage corresponding to the premiumamount comprises: generating, by the one or more computer processors, arespective premium payment quotation for each of several levels ofpossible employee absence coverage; receiving, from the proposed insuredby a communications device, a selection of one of the respective premiumpayment quotations corresponding to a selected level of employee absencecoverage; issuing, by the one or more computer processors, the insurancepolicy coverage corresponding to one of the respective premium paymentquotations and the selected level of employee absence coverage, whereinthe selected level of employee absence coverage corresponds to benefitduration limits based on a class of each of the plurality of employees;and transmitting, by the communications device, documents relating tothe insurance policy coverage to the proposed insured.
 17. Thecomputer-implemented method of claim 16, wherein each of the severallevels of possible employee absence coverage covers a different type ofpossible coverage.
 18. A computer system for issuing an insurance policyendorsement providing coverage for work absences, the computer systemcomprising: one or more data storage devices; one or more computerprocessors in communication with the one or more data storage devices; acommunications device in communication with the one or more computerprocessors and the one or more data storage devices; and a memory,coupled to the one or more computer processors, storing programinstructions which, when executed by the one or more computerprocessors, cause the one or more computer processors to: receive, viathe communications device, rating information with respect to a proposedinsured, the proposed insured being an employer of a plurality ofemployees; storing the received rating information in the one or morestorage devices; process the rating information to generate a respectivepremium payment quotation for each of several levels of possibleemployee absence coverage; receive, from the proposed insured, aselection of one of the respective premium payment quotationscorresponding to a selected level of employee absence coverage; issuethe insurance policy endorsement corresponding to the selected one ofthe respective premium payment quotations, wherein the insurance policyendorsement provides for reimbursement to the proposed insured for atleast some loss incurred by the proposed insured arising from a workabsence by at least one of the employees; and storing data indicative ofthe insurance policy endorsement corresponding to the selected one ofthe respective premium payment quotations.
 19. The system of claim 18,wherein the respective generated premium amount for each of the severallevels of possible employee absence coverage corresponds to a coverageduration limit based on a class of each of the plurality of employees.20. The system of claim 19, wherein the memory stores further programinstructions that cause the one or more computer processors to routedata indicative of the insurance policy endorsement and data indicativeof the respective premium payment quotation to a payroll servicescompany computer for preparation of a bill by a payroll servicescompany.